RUPTURED APPENDIX - Advanced appendicitis (delayed surgery) can result in a ruptured appendix. Clinically, the patient will have increased abdominal pain, diffusely over the entire abdomen (rather than just the right-lower quadrant. The fever usually becomes high-grade (over 101 degrees Fahrenheit), and the white blood cell count that typically exceeds 20,000 cells per cubic millimeter. Surgery for this condition is associated with higher morbidity.